摘要
Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use of flexible bronchoscope(FB) for the removal.This article summarizes the indications,methods and complications of SEMS removal by FB.Methods:We reviewed our experience with removal of SEMS using FB retrospectively.The clinical data on 29 patients with average age of(39.0±13.2) years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008.Results:Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents.The average duration of stent placement was(55± 94.7) d(0-472 d).Twenty-two procedures(59.4%) were performed under local anesthesia.The percentage of procedures under general anesthesia was 13%(3/24),67%(4/6) and 100%(7/7) for the short-term(≤30 d),medium-term(31-90 d) and long-term(>90 d) of stents placement,respectively.Indications for stents removal included migration in 15(40.6%),scar restenosis in 11(29.7%),airway shaping in 5(13.5%),stent fracture in 2(5.4%),stent incomplete expansion in 2(5.4%),improper size in 1(2.7%),mucus plugging with chest pain in 1(2.7%).And 85.7% of long-term stents were removed due to scar restenosis.The total success rate was 92%.There was no significant difference in success rate between the uncovered and covered group(82.3% and 100%,P>0.05).Complications were encountered in 13 patients,bleeding being the most common(53.8%).Conclusion:Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.
Objective： Placement of self expanding metallic stents （SEMS） is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope. There have been few reports published on use of flexible bronchoscope （FB） for the removal. This article summarizes the indications, methods and complications of SEMS removal by FB. Methods： We reviewed our experience with removal of SEMS using FB retrospectively. The clinical data on 29 patients with average age of （39.0±13.2） years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008. Results： Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents. The average duration of stent placement was （55±94.7） d （0-472 d）. Twenty-two procedures （59.4%） were performed under local anesthesia. The percentage of procedures under general anesthesia was 13% （3/24）, 67% （4/6） and 100% （7/7） for the short-term （≤30 d）, medium-term （31-90 d） and long-term （〉90 d） of stents placement, respectively. Indications for stents removal included migration in 15 （40.6%）, scar restenosis in 11 （29.7%）, airway shaping in 5 （13.5%）, stent fracture in 2 （5.4%）, stent incomplete expansion in 2 （5.4%）, improper size in 1 （2.7%）, mucus plugging with chest pain in 1 （2.7%）. And 85.7% of long-term stents were removed due to scar restenosis. The total success rate was 92%. There was no significant difference in success rate between the uncovered and covered group （82.3% and 100%, P〉0.05）. Complications were encountered in 13 patients, bleeding being the most common （53.8%） Conclusion： Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.
